Safe Laparoscopic Surgical Approach to GI Bleed in Jehovah’s Witness Patient

Emanuela S Alvarenga, MD, Heather Stewart, MD, Justin Lee, MD, Alexander Ramirez, MD, FACS. Florida State University

We aimed to present the succesul therapeutic approach utilizing laparoscopy for safely removing a Gastrointestinal Stromal Tumor. Depicted is a 66 year old Jehova's witness female who presented to the emergency department for evaluation of bitemporal headache and dizziness and found with profound anemia with hemoglobin 5.4 and hematocrit 16.6 upon arrival to ED. The patient refused blood transfusion as her religious beliefs, Jehovah’s Witness, preclude her from taking blood products. As part of her work up, endoscopy was performed and revealed a large, approximatelly 4 x 4 cm, prolapsed, ulcerated, nodular lesion with active bleeding in the cardia of the stomach. This was temporized but the friable tissue, with no single identifiable lesion for clip placement, left the patient at high risk for re-bleeding. She was taken to the operating room and Laparoscopic partial gastrectomy with intraoperative esophagogastroduodenoscopy were succefully perfomed, with minimall blood loss and no intra operative complications. Patient was discharged on post op day 3.